IndividualActive
Rosily Jacob
NPI 1114521275 · Pharmacist · Lakeland, FL
Provider details
- NPI number
- 1114521275
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- PS0031680 (FL)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
4005 US Highway 98 N
Lakeland, FL 33809-3815
Phone: (863) 815-9408
Approximate (ZIP-level) locationGet directions
Mailing address
1109 Glen Park Ln
Valrico, FL 33594-5112
Registry dates
- Enumerated
- 2020-11-29
- Last updated
- 2020-11-29
- Certified
- 2020-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.